Unless otherwise indicated herein, the materials described in this section are not prior art to the claims in this application and are not admitted to be prior art by inclusion in this section.
Surgical planning may involve identifying a surgical target or target region, and then selecting a surgical pathway to reach that surgical target. Selection of a particular surgical pathway is often based upon the access that the surgical pathway provides to the surgical target in view of the nearby anatomy. Better access to the surgical target may lead to a better surgical outcome.
However, better access to a surgical target is not the sole determinant of a successful surgical outcome. Another goal of surgical planning is to reduce collateral damage to the nearby anatomy. Collateral damage may include pathway trauma, which refers to damage incurred by dissection performed to reach the surgical target. In addition, collateral damage may include target trauma, or damage to healthy tissue that is adjacent to the surgical target that occurs when the surgical target is manipulated. The extent of target trauma is often dictated by the pathology of the surgical target. In contrast, pathway trauma might be reduced by appropriate selection of surgical pathways.
Selection of surgical pathways may begin with choosing a surgical portal, or opening, in the anatomy that is being operated upon. For example, in skull base surgery, transnasal portals have been identified that may form the entry point of surgical pathways into the skull base. Use of transnasal portals as part of the surgical pathway has led to reduced pathway trauma in some circumstances.
At the same time, rapid advances in many fields of surgery have led to the identification of new surgical pathways. Additional surgical pathways into the skull base as well as new surgical pathways to other anatomical features are likely to be identified in the future. By extension, the identification of new surgical portals has led to successful surgeries using multiple portals and pathways. Combined surgical approaches have significant potential to reduce collateral damage to healthy tissue.
However, the number of possible surgical pathways and combinations thereof is extensive. Moreover, because of the inconsistent and unpredictable nature of target pathologies, selection of an appropriate pathway or combination of pathways is often unintuitive. Therefore, a systematic approach to comparing, evaluating, and selecting between surgical approaches may improve surgical outcomes.